PLURALISMO MÉDICO Y ETNOMEDICINA ENTRE LOS TOBAS (QOM) DEL RÍO BERMEJITO (CHACO, ARGENTINA). DESAFÍOS Y APORTES PARA UNA GESTIÓN INTERCULTURAL DE LA SALUD EN EL IMPENETRABLE CHAQUEÑO / Medical pluralism and ethnomedicine among the Toba (Qom), Bermejito

• Main Author: Gustavo Javier Martínez
• Format: Article
• Language: English
• Published: Museo de Antropologia 2011-12-01
• Series: Revista del Museo de Antropologia
• Subjects: tobas; Chaco Central; Impenetrable; salud; interculturalidad; etnomedicina
• Online Access: http://revistas.unc.edu.ar/index.php/antropologia/article/view/5491

<p class="AIBR" style="text-align: justify;"><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">El presente trabajo se concibe en el marco de un estudio de la etnomedicina de los pueblos tobas (qom) del Chaco Central, Argentina, y  pretende mostrar - a partir de la caracterizaci</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n de la misma y del estado actual de los procesos de salud/enfermedad- algunos de los desaf</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">í</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">os que supone una gesti</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n intercultural en materia de salud en la regi</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n conocida como Impenetrable chaque</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ñ</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">o. Para ello nos detendremos en la consideraci</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n de tres aspectos: Las pr</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">á</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">cticas m</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">é</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">dicas tradicionales en el sistema sanitario local, la salud materno- infantil, y las problem</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">á</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">ticas de salud vinculadas al ambiente. Desde el punto de vista metodol</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">gico discutiremos algunos marcos te</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">ricos y el estado actual en torno a estas tem</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">á</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">ticas, a la luz de informaci</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n de campo obtenida de la conjunci</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n de t</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">é</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">cnicas cualitativas, cuantitativas y participativas. Analizaremos para ello la complejidad del sistema etnom</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">é</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">dico vigente en la regi</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n; los conflictos y articulaci</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n entre los diferentes escenarios y actores locales; las representaciones, pensamientos y praxis de las mujeres tobas vinculadas al ciclo vital; y por </span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ú</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">ltimo, los conocimientos, actitudes y pr</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">á</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">cticas de los nativos en relaci</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n con los cambios ambientales y con las enfermedades a ellos asociadas. Como s</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">í</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">ntesis y corolario de cada una de estas tem</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">á</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">ticas, exponemos posibles lineamientos y sugerencias en orden a la gesti</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n intercultural de la salud, considerando el contexto de pluralismo m</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">é</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">dico vigente, as</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">í</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD"> como el aporte de diversos enfoques interdisciplinares de investigaci</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n y acci</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">n, tales como las perspectivas etnoecol</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">ó</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">gicas y los estudios de epidemiolog</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">í</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">a cr</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";;" lang="ES-TRAD">í</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">tica y comunitaria.</span></em></p> <p class="AIBR" style="text-align: justify;"><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD"> </span></em></p> <p class="AIBR" style="text-align: justify;"><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";;" lang="ES-TRAD">Palabras claves: tobas; Chaco Central; Impenetrable; salud; interculturalidad; etnomedicina.</span></p> <p class="MsoNormal" style="margin-bottom: 0.0001pt;"><span style="font-family: 'FrutigerNextLT Regular';"> </span></p> <p class="MsoNormal" style="margin-bottom: 0.0001pt;"><strong><span style="font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-ansi-language: EN-US;" lang="EN-US">Abstract</span></strong></p> <p class="AIBR" style="text-align: justify;"><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";; mso-ansi-language: EN-US;" lang="EN-US">The following article is conceived as part of a study of ethnomedicine of the people Toba (Qom) of the Central Chaco, Argentina, and aims to show - by characterizing of it and of  the current state of health and disease processes - some of the challenges of intercultural management in health in the region known as "Impenetrable chaque</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";Times New Roman";,";serif";; mso-ascii-font-family: ";FrutigerNextLT Regular";; mso-ansi-language: EN-US;" lang="EN-US">ñ</span></em><em><span style="mso-bidi-font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-bidi-font-family: ";Times New Roman";; mso-ansi-language: EN-US;" lang="EN-US">o". To do this, we will stop at the consideration of three aspects: traditional medical practices in the medical local system, maternal-infant health, and health problems related to the environment. From the methodological point of view we discuss some theoretical frameworks and current status on these issues by analyzing fieldwork information obtained from qualitative, quantitative and participatory methods. In the analysis we consider the complexity of the current ethnomedical system in the region; the conflicts and coordination among the different scenarios and local actors; representations and ways of thinking and acting of Toba women linked to the life cycle; and finally, knowledge, attitudes and practices of the natives in relation to the environmental changes and diseases associated with them. As a corollary and synthesis of each issue, we discuss possible guidelines and actions in order to the intercultural management of health, considering the current context of medical pluralism and the contribution of various interdisciplinary research approaches, such as ethnoecological perspectives, and the studies from critical and communitarian epidemiology.</span></em></p> <p class="MsoNormal" style="margin-bottom: 0.0001pt;"><strong><em><span style="font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-ansi-language: EN-US;" lang="EN-US"> </span></em></strong></p> <p class="MsoNormal" style="margin-bottom: 0.0001pt;"><span style="font-size: 10.0pt; font-family: ";FrutigerNextLT Regular";; mso-ansi-language: EN-US;" lang="EN-US">Key words: Toba, Central Chaco, Impenetrable, health, multiculturalism, ethnomedicine.</span></p>